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Individual

CHRYSTA IROLLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, MSPO, CPO

Contact information

Practice address
1825 4TH ST RM M5302, SAN FRANCISCO, CA 94143-2350
(415) 476-1788
Mailing address
400 PARNASSUS AVE # 614, SAN FRANCISCO, CA 94143-2202
(415) 476-1788

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CPO03368
AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS, INC.
Enumeration date
03/18/2019
Last updated
03/18/2019
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